Research corner:Cystic Fibrosis Phage Therapy Study at Yale
By Ella Balasa
As someone who has received phage therapy through compassionate use in 2019 due to facing a very drug resistant infection, I am excited about the advent of new clinical trials looking at phage therapy in CF! This study one of a few trials either underway or initiating soon in using phage therapy as a novel method of clearing lung infections.
I tried phage therapy at a time when I had been battling a severe exacerbation for over a month having been on strong IV antibiotics, and I still had a persistent infection and required supplemental oxygen constantly. I inhaled phages for one week and at first, I didn't feel a difference but after the week, I started clearing the mucus faster than I have ever cleared an exacerbation before. I had used this particular cocktail of antibiotics many times in the past, so I knew it was the addition of phages changing the sensitivities of the bacteria to the antibiotics, and within days I was coughing out brownish, dead bacteria from deep in my lungs.
I published an article in HuffPost about my experience in more detail for those interested. Since sharing my experience, I have connected with families of those that have pioneered phage treatment in CF and those with CF that have had phage therapy since hearing my own story.
So how does phage therapy work and how does it differ from other ant-infective options like traditional antibiotics?
Phages are specialized viruses that kill specific bacterial strains. They are found abundantly in the environment and are the natural predators of bacteria. They can be used to target specific hosts, such as certain strains of Pseudomonas and other disease-causing bacteria commonly found in CF lungs.
Similar to antibiotics, they bind to bacteria, but unlike antibiotics -- which are small molecules that inhibit the bacteria replication or metabolism processes -- phages inject their own DNA into the bacteria, causing the bacteria to start replicating more phages inside of itself until the bacteria bursts and dies. This results in the bacteria releasing the new phages, and they spread to continue killing off more harmful bacteria.
Unlike a virus -- like the cold or the flu -- that infects humans, phages attack only specific bacteria that they are programmed to attack and have been shown to be generally safe. Phage therapy is not a novel treatment. It was used decades ago and was largely abandoned in the West as antibiotics were developed and manufactured commercially with greater ease.
If you would like to read more about the science of phage therapy read this interview with the former CFF senior director of drug discovery and development.
What will be the upcoming trials goals?
Pseudomonas aeruginosa is the most prevalent bacterial infection in adults with cystic fibrosis and is often associated with a decline in lung function. This study will provide very important information about the use of bacteriophages (phages), as a new anti- Pseudomonas aeruginosa treatment. The study will investigate how safe and effective phages are to treat Pseudomonas aeruginosa.
This study includes visits to the Yale New Haven Hospital for the first 2 months, followed by 4 months of alternating in-person visits and phone calls. Blood test, sputum samples, spirometry, and questionnaires will be obtained to monitor your health. Phage will be provided to you and you will be instructed on how to take it.
Would you qualify?
If you are an adult with CF who is colonized with Pseudomonas aeruginosa and have FEV1 > 40% you may be eligible to participate.
Are you interested in learning more and participating?
If you have any questions or would like to join the research study, please contact the study coordinator Claire Cochrane at 203-430-8391 or by email at firstname.lastname@example.org.
About the Author: Ella is a director for USACFA. She was diagnosed with CF at 18 months old. She has a B.S. in biology and serves on various research committees, authors journal submissions, and shares her health journey to provide a scientific voice and encourage empowerment to the CF community. She also writes about the hardship yet triumph of chronic disease. When she is not taking care of her health, she enjoys cooking, drawing, and spending time with friends. View more of her work and experiences on her website, www.ellabalasa.com.